Help me out of this downward spiral?

February 20, 2008 1:45 PM

So I'm clinically depressed. And right now I likely can't take medication or see a therapist. If things get worked out with medical coverage I might be able to do one or both. But, I'd like to avoid medication if at all possible. What are the things I can do/take (vitamins?) to feel better until ?

I'm off medication because we are trying to have another child. Our first is nearly 6. I have had 3 miscarriages and a huge number of problems in the last year (stepfather stroking a number of times, the last on Xmas day, surgery, a recent move away from a city and to a small town, deaths, pet deaths and more...2007 just sucked).
I'm also unemployed currently, which isn't a financial problem, I left work to be with our child, but she's 6 and unless I'm actively raising a wee child, there’s no need for me to be at home and I’m wasting a large education. I am trying to change my career from IT (15 years) to Education which requires study for the Teacher exams but I can't concentrate.

I've lost my drive, my passion, my ambition. I used to have big energy and a wide ranging interest and all I want to do now is sleep, read and sleep some more. I'm managing to pull it together around my daughter and to keep our house running, but I'm a void otherwise. I'm going through the motions and that is not me.

After we determine that I either cannot carry another child or after a successful pregnancy I'll be back on meds like a flash, but for now I can't. And until our therapy coverage is figured out I can't do that either.

I've stopped writing (I’ve had a blog since 1998); stopped participating in online discussions, stopped interacting much with anyone. When I do, I keep ending up in situations I am uncomfortable in (like a bar) then I drink too much and make an ass out of myself and of course hate myself even more. I need to see my friends though or I'll isolate further. Also I don't drink every day or every week, but go overboard when I'm in certain social situations or sometimes when blindsided by something horrible (not always but sometimes). It’s hard to give up drinking entirely because that is about the only time I feel some relief and ease.

Also--I have a congenital defect which makes exercise difficult (I only have about 70 lung capacity and my organs are not all located exactly where they should be, wheee). I know I need to though. But what? And how to get off your butt when everything is a huge effort?
I have had episodes of major depression in the past, all dealt with by some very competent doctors and I've survived more or less. I have a great daughter and husband and live in a good town with good friends. This exam is coming up and if I don't get my brain back I'm going to fail and hat myself more. Becoming a teacher is something I wanted when younger and was talked out of, now is my chance, the jobs all just opened up and if I can get my butt in gear and take these tests and get in the non traditional licensure program I will get to do what I wanted to do in my 20s. But I can’t think or remember or even learn right now. It's all a bad spiral. And I’m also around mid life crisis age too, give or take. Which means I’m running out of time to be pregnant too .


I'm usually more linear but it is hard to describe all this. So vitamins? Which ones? How much? Motivation? Exercise? What kind. I’d jump off the roof, but it would really piss off my cats and probably be worse for my family then even how I am right now. Throwaway email is [e-mail]

posted by anonymous to health & fitness (40 answers total)

I am so sorry. It sounds like you're in the whirlwind. People will have a lots of better advice than me; but for what it's worth I have always been surprised how much better I feel when I take B-Complex vitamin every day. I don't know how to describe the difference. I can just handle stress better, and it seems to work quickly, too. (IANAD.)
posted by milarepa at 1:55 PM on February 20, 2008

Eat better.

Go on walks.

Buy some 5-HTP, its more or less an OTC ssri.

Spend a little time trying to learn relaxtation techniques or straight-up meditation.

Spend some time around people who are much worse off than you.
posted by damn dirty ape at 2:05 PM on February 20, 2008 [2 favorites]

I absolutely second the B-Complex vitamins. I have never been depressed, but definitely "moody" and those help a lot.
posted by sweetkid at 2:18 PM on February 20, 2008

I have been on the protocol prescribed by these guys for about 2 months now, and it is working pretty darn good.

www.neurogistics.com

I like their concept, because the idea is to see specifically what neurotransmitters YOU in particular have low levels of, vs. say, shotgunning random supplements from your pharmacy. Not that that couldn't work, I just think this is a lot more efficient.

My doctor works with them so it's also not like its just some random bogus quackery,either, in addition to the fact that this stuff has been used in europe for quite a while. Which is not to say there aren't doctors that are full of b.s., just that since my doc has been highly rated, that helped give it some more credibility for me to bother.

They will of course tell you to also likely take omega-3's, drink a good amount of water, exercise (it sounds hard for you, but if there's SOMething you can do, I really, really recommend it), the B-vitamins (particularly B-12).

This stuff doesn't all work overnight though.

Also remember: "I have a great daughter and husband and live in a good town with good friends." It might not seem like a lot, and yeah, the grass is always greener, etc. but doing what you have to do now with that situation is much better than the alternative.

You can do it!

Finally: I'm not "anti meds", I just think that this is one amongst several solutions for situations like yours that may or may not require them. If you can afford it, it can't hurt to try.

good luck! : )
posted by bitterkitten at 2:21 PM on February 20, 2008 [1 favorite]

some kind of physical activity will help, even if it's just going for a walk or doing yoga. can you join a yoga class at a nearby gym? that will get you out of the house and interacting. there are surely beginners' classes in your area.

i found st. john's wort to be helpful in the past. some people swear by b-complex vitamins. i don't know if they work, but they're good for the folic acid, too, which is good for pregnancy, so you might as well load up.

totally unscientifically, i find that cutting refined sugars and starches out of my diet improve my mood and sleep somewhat. i don't know why--i guess it's because it keeps your insulin on a more even keel.

and don't worry about the things you haven't done. so you haven't written in a while. stop trying for now--it'll just stress you out. try painting or drawing or something else creative.
posted by thinkingwoman at 2:23 PM on February 20, 2008

I've been taking 5-HTP for a while, and my spouse has said he's really noticed a difference. It's very inexpensive and can be bought at most vitamin stores. Please get some.

And I also second (third? fourth?) the suggestions of trying yoga, walking, or some sort of light exercise that you can handle. Studies have been done that show exercise can help alleviate depression just as well (if not better) than drugs. Plus, it'll help with your lack of energy you're experiencing.

Also, get outside. Maybe on those walks. Sunlight is supposed to be great for alleviating depression.

I understand what you're going through, and I hope something works for you. It's horrible feeling this way.
posted by polyester.lumberjack at 2:29 PM on February 20, 2008

Nthing, 5-HTP and be sure to take them with a B-Complex vitamin.

Yoga should also help. Even if you can't do a strenuous class, the breathing and mediation will strengthen the mind-body connection and help you to heal.

You should reconsider trying to conceive right now. If you're depressed now, getting pregnant can send you right around the bend. Hormonal changes during and after pregnancy can exacerbate depression and bring on depression (e.g. post-partum depression).

I would also recommend looking for a medication that is safe while pregnant or trying to conceive. They exist, but are expensive. I know of women who have been treated prophylatically for depression while pregnant because they have a history.

Good luck.
posted by mausburger at 2:30 PM on February 20, 2008

Has St. John's Wort been discredited?
posted by mecran01 at 2:32 PM on February 20, 2008

If you are already depressed and experience moodiness, pregnancy will probably not enhance your mental state (but who knows, maybe you found it to be positive when you conceived your last child?).

That said, eat right and exercise, but you know this already. Take the B-Complex, my nurse practitioner has recommended that as essential to any woman who has any hint of mood swings or pre-menstrual/hormonal issues.

With regards to exercise, make yourself take walks every day. If she isn't too big, push your six-year-old in a stroller for a half-hour or so every day. At least do that. Make it a habit, so when you're not feeling it SHE will and will bug the heck out of you to go. Increase length and intensity as you feel able.

Cut down on refined sugars and grains, as a previous poster said. Replace them with eating plenty of vegetables. Whole, leafy, vegetables, vegetables with lots of deep colors to them. Fruits, too. Seriously, you would not believe the effect improving one's diet has on mood. It sounds too trite to be true, but it really can work. Don't think about it as a diet, think about it as medication. Your medication is a couple cups of leafy vegetables per day and some sort of whole fruit or vegetable with every meal. This medication is counteracted by eating crap high in sugar and trans-fats.

And like SSRIs, you have to stick to the program to make it work. SSRIs can take weeks to work--so does this. You gotta be patient with it.
posted by schroedinger at 2:38 PM on February 20, 2008 [1 favorite]

n+1 on 5-HTP. The workable dose varies per person - initially I took too much and felt "foggy" for a few days. I take a 50mg pill 2 to 6 times a week depending on mood.
posted by MillMan at 2:40 PM on February 20, 2008

On the introspection end of the spectrum, I HIGHLY recommend the book "Feeling Good." Lots of good exercises and recommendations, to help you to think better about your thinking. It was a big part of a major recovery I made almost a year ago. If it's too hard to get up and do anything, at least you can sit and read. :)
posted by epersonae at 2:56 PM on February 20, 2008

exercise while you're able should help (I don't, but all the studies show it is at least as effective as meds).
posted by Grod at 2:56 PM on February 20, 2008

oops, sorry, I didn't see the last part. Still, there should be some things, walking, biking, gardening?
posted by Grod at 2:57 PM on February 20, 2008

Get an adrenaline high: go race go-karts or go sky-diving or go to a big loud rock show or have your friend dress up as Leatherface and chase you down the road while brandishing a chainsaw (ok, maybe not that last one).

Seek high-intensity stimuli.

Sure, it's a temporary fix. But an adrenaline buzz really does a great job of blowing those cobwebs out of one's mental attic.
posted by BitterOldPunk at 3:08 PM on February 20, 2008

I've been chronically depressed for a very long time, mostly without insurance, and I've tried lots of meds and supplements. If you have a problem and want to stay clean for a possible fetus, why would you take a supplement (like 5-HTP or St. John's Wort) which hasn't been tested and isn't regulated like a prescription med? My advice:

1. try ECT: it's pretty cheap when done on an outpatient basis, and it is expressly used for patients who can't tolerate side effects, like pregnant women and the elderly. I've tried it and found it very effective. The only side effect some residual memory loss on the day of treatment.

2. try cognitive-based therapies, some which you can do on your own. A good place to start is with Tal Ben Shahar's lectures on Positive Psychology. I've found them very helpful.
posted by RussHy at 3:10 PM on February 20, 2008

5-HTP gives me whacking great headaches, which you might not see mentioned as a side effect. Please be aware of that if you follow the suggestions here to take it.
posted by Squeak Attack at 3:10 PM on February 20, 2008

I've recommended this a few times on here, but Feeling Good really helped me through a tough time. It's a classic; basically cognitive therapy in a book.
posted by Defenestrator at 3:21 PM on February 20, 2008

I can't figure out why you are trying to have a child when you are feeling this way. Childless, 32, so have no perspective on this kind of thing but isn't it more important to feel well than to have a child? Seems like it would be best for both you and any prospective child to get yourself feeling better before you take on such a momentus thing. You have career, possible child and your own depression all up in the air...I think you should take care of 1 and 3 before 2. But again, 32 year old single male so I don't know anything.
posted by sully75 at 3:23 PM on February 20, 2008 [2 favorites]

Has St. John's Wort been discredited?

You might be thinking of its interactions with other medications.
posted by gimonca at 3:29 PM on February 20, 2008

--If you start to feel suicidal, please call 1.800.442.HOPE or 911. If there are firearms in your home, ask your husband to remove them.

-- You can pay for therapy out of pocket. I know it costs money, but you need to make it work. You need the help. Please consider seeing someone at least once every two weeks.

--Try your best to stop drinking. I know it's hard. See if there's an AA meeting near you. You aren't necessarily an alcoholic, but you do need help to stop drinking. You don't need to chose between your friends and drinking. They will do other things with you. Tell them you can't drink right now. They will understand. They will support you.

--Walk around the block at least once a day. If if feels good, keep walking. Go as slowly as you want. Ask a friend to walk with you, or make a date with a neighbor who likes company.

--Watch familiar movies or TV shows. Your brain mistakes people on TV for real people--so it can be comforting.

--You can always retake your teaching exams. You can still pursue your dreams. It is not a "now or never" situation.

--Don't give up hope.
posted by sondrialiac at 3:39 PM on February 20, 2008

How about having a walk to the local playground with your husband and child every day? He can provide the motivating force (if he's got time); it would be good for all of you. You may need a little more sunlight in your life, and this could help in so many ways.

Gardening helps me a lot, too, I have to say.
posted by amtho at 3:40 PM on February 20, 2008

Okay, you didn't ask about SSRI's and pregnancy, but I'm going to put it out there just in case.

I have chronic depression that has been passed down to me through both sides of my family. I really debated about the pregnancy and antidepressant thing. Finally, I went to a specialist in pregnancy and depression. They are rare, but they exist. Here is the center for perinatal depression in Chicago. They might be able to direct you to someone in your area if you are interested.

After doing a LOT of research and talking to Dr. Miller there, I decided to switch meds to Zoloft before even getting pregnant and staying on meds during the pregnancy. There are risks to being pregnant and fighting depression that can affect the health of the baby AND the mother that I was not willing to take. I already knew that I had a problem with cortisol and stress when I was not being treated before depression and I did not want that to affect the development of the baby. After pouring over the data with Dr. Miller's help, I decided to take Zoloft which was appropriate for my type of depression and has a very good track record for pregnant women and babies. It has been around long enough that there have even been studies done of older children whose mothers took Zoloft during pregnancy.

The bottom line is this...I could not have handled my pregnancy with depression and no treatment. I would not have taken care of myself (and therefore, my baby). I enjoyed pregnancy, had a good delivery and am now the mother of a lovely, smart and lively two year old.

You and your doctor will know what is best for you and your pregnancy. You may decide to go med-free and that is totally fine. Especially if you can find relief from some of the great suggestions here. But also ask your OB/Gyn about the affect of your depression on getting pregnant and experiencing a healthy pregnancy. Weigh the benefits and risks of your choices. And don't let yourself suffer without knowing all of the information on those choices.

Best of luck and take very good care.
posted by jeanmari at 3:54 PM on February 20, 2008 [3 favorites]

Getting out in sunlight will help, also b vitamins and omega-3 oils (flax seed or fish oil. I like the flax seed myself.) Also, walks. You don't have to exercise heavily to get the antidepressant effect-in other words you don't need to get out of breath-long walks would be perfect.

Also, here's a little trick. line up a series of songs on your ipod if you have one-or you can do this via youtube or however you like-start with songs that match your mood and slowly progress to songs that sound happier and happier. Starting out with happy stuff will only annoy you, but starting where you are moodwise and working your way up with the songs actually does have a good effect.

Also fwiw to me this sounds like maybe it isn't so much depression as it is grieving for your losses. Take time to grieve those losses.

And between you and me, you joked about it and I understand gallows humor, but you know yourself: if you really are thinking about death and suicide a lot you need to see a doctor. It would not be overkill (pardon the bad pun) to go to an ER if that is the case. Obviously it may not be, but don't take a chance if it is. Cause you don't need to piss off the cats. ;-)
posted by konolia at 3:55 PM on February 20, 2008 [2 favorites]

Rebuild from Depression Blog is a good place to start. Most advice is all about getting a good micronutrient balance and making sure to balance your omega-3:omega:6 ratio by eating more omega-3 and less omega-6. But what I've found is that while a good diet helps smooth my mood, it's not going to get rid of unemployment, which is a good reason to be depressed.

I don't know what doctors who prescribe pills are thinking when they give them out to people who are depressed for a reason. A shrink suggested them for me when I was going through a bad break up...I guess they might have been OK, but I didn't want them to be my first stop on the road to recovery.

For me diet was a good release though. It allowed me to focus on something that had results. I did a raw vegan diet for awhile and gradually moved to a "paleo" diet. The optimal diet for me I found ended up being high in fat. I guess that makes sense, because the brain is a very fatty organ.

Also, you might try to find a mild yoga class. They have ones that are targeted to people who may be recovering from injuries or are otherwise less able to tolerate extremehardcorebendystuff.
posted by melissam at 4:20 PM on February 20, 2008

It might be the case that the most healthy thing you can do for your child and your future child is to take care of yourself and get your mental health back on an even keel for a few months before trying to conceive again. Drugs could help get you through this rough patch following your significant losses and challenges, and then you could explore going off medication when you start trying to conceive again (though pregnancy on meds, as discussed above, is certainly an option many people choose for the best possible outcome for both mother and child). It just sounds like you are in a really rough place right now and have to take care of yourself first. Good luck.
posted by judith at 4:21 PM on February 20, 2008

Look up "selenium" and "moods" on Google, there have been some studies done on that. Also, if you choose to do yoga, there is a great book called "Babar's Yoga for Elephants," which is lightheated and uplifting and could also be done with your daughter.

Perhaps hunt down your local community/county/state mental health services and see if there's some sort of free or sliding scale mental health treatment available. You might be able to get into see a therapist cheaply, talk about what you've gone through, and then decide the med thing.

It seems like a lot of pressure to get pregnant and worry about a miscarriage and pass a teacher's exam in the same timeframe. The stuff you've gone through would depress anyone, and if you have a tendency toward depression, you've had a lot of triggers to add to the mix. Would it ease your stress to delay the teacher's exam until you've decided about the baby thing? And you're not wasting anything by spending time with your daughter, 6 year olds are still babies in my mind.

Wishing you the best of luck and hang in there.
posted by Marie Mon Dieu at 4:24 PM on February 20, 2008 [1 favorite]

If you are feeling suicidal, talk to someone today. Whether it's the Hopeline sondrialiac mentions above or to your husband or a trusted friend or family member - it can be a huge turning point for the better. Keep in mind that there is absolutely no shame in feeling this way and it does not make you a bad person or a burden. Some of the strongest and wisest people I've ever known have contemplated suicide at one point or another; same is true with a lot of wonderful, respectable, loveable people.

I had to do exactly that four years ago. I met with a friend one day after work, blurted it out, we called a hotline together. Nothing more drastic happened that day -- it was a few weeks before I started therapy, and several months before I was prescribed medication -- but the simple act of putting it out there, admitting it out loud to someone I trusted and to myself, was a very real turning point, the moment I started feeling better. Talking to someone about this will subtly change your perspective from "this depression is taking over my life" to "I don't want to feel like this and I am willing to fight it." You've already stated here that you want to conquer it, which is a great start.

There are people in your life who love you and want to help you and want to know what you're feeling. If you haven't already, tell them. Even if you are not suicidal, telling someone you trust about what you're going through will help you, and it will help them help you.

Many people have been in this same spot -- I say that not to diminish the validity your pain right now, but to emphasize that you are not alone and that your pain is very real and understandable. Many people have gotten through it, and I have absolute faith that you can too.
posted by Metroid Baby at 4:59 PM on February 20, 2008

Omega 3's
Light exercise (walking etc.)
Quit drinking
Watch funny movies, TV shows, etc.

Good luck! I hope you feel better soon!
posted by Jacqueline at 5:17 PM on February 20, 2008

all of the advice is good, but just for a quick mood boost, eat something spicy. The brain releases adrenaline, just like if you had a scare.
posted by Sara Anne at 5:46 PM on February 20, 2008

Omega-3's and yes, seconding the person who said SSRI's are actually safer for a pregnancy than depression is if the depression is severe. Just avoid Paxil (paroxetine).

Good omega-3's may well cost you as much as a generic antidepressant, however.

Some people find SAM-e helpful, but also expensive.

Nthing cognitive therapy and light exercise as well. Swimming perhaps?

Light therapy can also be useful-- this time is typically the pits for people with seasonal affective disorder and so you might try getting a light. Be aware if you have any manic tendencies that you should use the light mid-day, not in the morning-- I found that it made me slightly hypomanic if I did first thing in AM.

Also, you will have to stop drinking if you get pregnant anyway and drinking can reduce the odds of conception if not done in extreme moderation (no more than one drink on any given day). It can also exacerbate depression. I wouldn't worry about AA unless you find that you try stopping and cannot do it on your own.

Finally, are you charting your cycle? This might help you not only conceive but also understand if there are hormonal aspects to your mood. www.ovusoft.com for good software if you don't already have.

It occurs that the miscarriages may be what has done your mood in-- hormonally, these can cause depression, not to mention the mental anguish of them. So cognitive stuff may help with that and also, might be worth just getting a full work up just to see where you are at even if you can't afford ongoing treatment.
posted by Maias at 7:07 PM on February 20, 2008

I know a good therapist in DC who sees people without insurance on a sliding scale based on their income. I bet there are lots of docs like that.
posted by meta_eli at 8:16 PM on February 20, 2008

Is this really the right time to be having a second child? You're depressed and changing careers, and your first kid needs you, even if it is in school. Think about yourself before thinking about pregnancy.
posted by stereo at 8:49 PM on February 20, 2008

Also referenced in an above link--the connection between some herbal remedies recommended for depression and difficulty becoming pregnant.

Many women wonder whether herbal products would be effective and safer than prescription antidepressants. Unfortunately, there is no evidence from studies so far that any herbal product is effective for treating perinatal major depression. Some commonly used herbal remedies can interfere with fertility and can make the uterus contract, so it’s not true that herbal products can be assumed to be safe just because they are “natural”.

Check with your doctor if you are considering taking the herbal route. They might be able to steer you away from those which may interfere with your fertility.

I know that you said you cannot afford a therapist currently. Is a there a chapter for something like the UK's Depression Alliance near you? Or the DBSA? They may know of groups that meet until you can arrange for your own therapist. I found this blog carnival entry about the connection between cognitive thinking and CBT with reducing depression to be fascinating and helpful in understanding how talk can be leveraged just like meds can.

Finally, if it is as bad as you may be hinting at, please consider putting everything else aside for now--school, a potential pregnancy--to get treatment for yourself. If not for you, then for your daughter. As the child of a chronically depressed mother who refused to seek help, I can tell you that the best mothering you can do is to take care of your depression first. Your depression will affect your daughter in some way. You cannot hide it as well as you think you can. My mother did the best she could, but she was often absent--physically and emotionally--as a result of her struggle. This created problems for me as a child and the aftereffects continued into adulthood for me.
posted by jeanmari at 8:58 PM on February 20, 2008

Sometimes having a routine and actually getting something done in the day can help raise your mood. Check out flylady.org - she is opinionated but if you give the system a chance it can help make sure that you get the minimum done to provide a home that you can feel good about it.
posted by metahawk at 9:19 PM on February 20, 2008

I had depression for about 22 years and finally fixed it when I starting eating more fresh foods, particularly vegetables and protein, exercised (just a little), stopped drinking alcohol so much, and got enough sleep. Meds didn't help.
posted by fan_of_all_things_small at 2:45 AM on February 21, 2008 [1 favorite]

Exercisewise I'd recommend T'ai Chi. Very good for depression, stress, etc, very gentle but surprisingly effective
posted by criticalbill at 3:25 AM on February 21, 2008

Regarding the 5-HTP suggestions.... be careful with that stuff. It's not just a vitamin. It really does boost your serotonin levels.

For some people that's a good thing... for others... Well, I tried it and it was like I took half a hit of acid. It was a very freaking weird experience. (and not one I needed at that particular moment in life).
posted by Bighappyfunhouse at 4:10 AM on February 21, 2008 [2 favorites]

I just wanted to say good luck. Don't stress about the tests or finding teaching jobs, those opportunities will wait for you. It's okay if not everyone works out at once.
posted by lullabyofbirdland at 11:08 AM on February 21, 2008

everyone everything
posted by lullabyofbirdland at 11:10 AM on February 21, 2008

Have you considered trying acupuncture?
posted by mshields at 9:55 AM on March 19, 2008